Submitted by Dele Ogunleye, MD, Advanced Women’s Healthcare
The term “pelvic floor” refers to the group of muscles that form a sling or hammock across the pelvis. Together with their surrounding tissues, these muscles hold the pelvic organs — which in women include the uterus, cervix, vagina, bladder, urethra, small intestine and rectum — in place so that they can function correctly. You may be surprised to know that more than one-third of women in the United States have some sort of pelvic floor disorder, often referred to as PFD. Furthermore, an estimated 377,000 women underwent surgery in 2010 to correct a pelvic organ prolapse or bladder control problem and this number is projected to rise sharply over the next several decades.
A pelvic floor disorder occurs when the pelvic muscles and connective tissues weaken or are injured. The most common types of PFDs are:
- Pelvic organ prolapse. A “prolapse” occurs in women when the pelvic muscles and tissue can no longer support one or more pelvic organs, causing them to drop or press into the vagina. For instance, in uterine prolapse, the cervix and uterus can descend into the vagina and even come out of the vaginal opening. In vaginal prolapse, the top of the vagina loses support and can drop through the vaginal opening. Prolapse can also cause a kink in the urethra, the tube that brings urine from the bladder to the outside of the body.
- Bladder control problems. The leaking of urine (urinary incontinence) can occur in women or men when the bladder falls from its proper place. Other symptoms include a sudden, strong urge to urinate.
- Bowel control problems. The leaking of liquid or solid stool from the rectum, called fecal incontinence, can occur in women and men when the rectum is out of place. It also can occur if there is damage to the anal sphincter, the ring of muscles that keep the anus closed.
What causes PFD?
Pelvic floor problems are caused by a combination of factors including pregnancy and childbirth; heredity; and activities that put pressure on the pelvic floor such as being overweight or obese, chronic constipation, or chronic coughing from smoking or other health problems. But there is no one definite cause and it can affect people of all ages.
What are the symptoms?
Because there are different types of PFDs, symptoms of different PFDs can overlap. Following are the most common symptoms:
- Feeling of heaviness, fullness, pulling, or aching in the vagina that worsens by the end of the day or when having a bowel movement
- Seeing or feeling a “bulge” or “something coming out” of the vagina
- Having a hard time starting to urinate or emptying the bladder completely
- Having frequent urinary tract infections.
- Leaking urine when coughing, laughing, or exercising
- Feeling an urgent or frequent need to urinate
- Feeling pain while urinating
- Leaking stool or having a hard time controlling gas
- Constipation
- Having difficulty making it to the bathroom in time
Some women with pelvic floor problems do not have symptoms at first. And many women are reluctant to tell their health care provider about embarrassing symptoms. In addition, some women think that problems with bladder control are simply a normal part of getting older and learn to live with their symptoms. However, there are many treatment options available so no one should have to put up with the frustrating and sometimes painful symptoms of PFD that can severely affect your quality of life.
Next month: Treatment for Pelvic Floor Disorders
Dele Ogunleye, MD, provides a full range of obstetric and gynecologic services. He is subspecialized in urogynecology so he has particular expertise in treating pelvic floor disorders. In addition, his office includes the services of Gretchen Dean, a physical therapist specially trained to treat women who suffer from PFD. You may contact Advanced Women’s Healthcare at 309-808-3068 or www.awhcare.com. Their office is located at 2111 East Oakland Avenue (Next to the Jewel-Osco Plaza).
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